Surgical device

ABSTRACT

A surgical device includes a first jaw and a second jaw disposed in opposed correspondence with the first jaw. The second jaw is mechanically coupled to the first jaw at a proximal end opposite a distal end. A cutting element is disposed within the second jaw, and a first driver is configured to move the cutting element proximally from the distal end toward the proximal end of the second jaw to cut a section of tissue disposed between the first and second jaws. The device may also include a stapling element disposed within the second jaw. The cutting element and the stapling element may be contiguous so as to define a cutting and stapling element, such as a wedge having a blade disposed thereon. As the wedge is moved proximally from the distal end of the second jaw to the proximal end, the wedge pushes a plurality of staples against a plurality of opposing staple guides disposed in the first jaw in order to staple a section of tissue while cutting the section of tissue.

CROSS-REFERENCE TO RELATED APPLICATIONS

The present application incorporates herein each of the followingreferences as fully as if set forth in their entirety: U.S. patentapplication Ser. No. 09/887,789, filed on Jun. 22, 2001; U.S. patentapplication Ser. No. 09/836,781, filed on Apr. 17, 2001; U.S. patentapplication Ser. No. 09/723,715, filed on Nov. 28, 2000; U.S. patentapplication Ser. No. 09/324,451, filed on Jun. 2, 1999; U.S. patentapplication Ser. No. 09/324,452, filed on Jun. 2, 1999; U.S. patentapplication Ser. No. 09/351,534, filed on Jul. 12, 1999 and issued asU.S. Pat. No. 6,264,087 on Jul. 24, 2001; U.S. patent application Ser.No. 09/510,923, filed on Feb. 22, 2000; and U.S. patent application Ser.No. 09/510,927, filed on Feb. 22, 2000.

FIELD OF THE INVENTION

The present invention relates to a surgical device. More specifically,the present invention relates to a linear clamping, cutting and staplingdevice for clamping, cutting and stapling tissue.

BACKGROUND INFORMATION

The literature is replete with descriptions of surgical devices.Applicant's co-pending U.S. patent application Ser. No. 09/887,789 listssome of these surgical devices, such as U.S. Pat. No. 4,705,038 toSjostrom et al.; U.S. Pat. No. 4,995,877 to Ams et al.; U.S. Pat. No.5,249,583 to Mallaby; U.S. Pat. No. 5,383,880 to Hooven; U.S. Pat. No.5,395,033 to Byrne et al.; U.S. Pat. No. 5,467,911 to Tsuruta et al.;U.S. Pat. Nos. 5,518,163, 5,518,164 and 5,667,517, all to Hooven; U.S.Pat. No. 5,653,374 to Young et al.; U.S. Pat. No. 5,779,130 to Alesi etal.; and U.S. Pat. No. 5,954,259 to Viola et al.

One type of surgical device is a linear clamping, cutting and staplingdevice. An example of such a device is shown and described in U.S. Pat.No. 6,264,087 issued on Jul. 24, 2001. Such a device may be employed ina surgical procedure to resect a cancerous or anomalous tissue from agastro-intestinal tract.

With respect to the structural features of the conventional linearclamping, cutting and stapling instrument which is shown in FIG. 1, thedevice includes a pistol grip-styled structure having an elongated shaftand distal portion. The distal portion includes a pair ofscissors-styled gripping elements, which clamp the open ends of thecolon closed. In this device, one of the two scissors-styled grippingelements, the anvil portion, moves or pivots relative to overallstructure, whereas the other gripping element remains fixed relative tothe overall structure. The actuation of this scissoring device (thepivoting of the anvil portion) is controlled by a grip triggermaintained in the handle.

In addition to the scissoring device, the distal portion also includes astapling mechanism. The fixed gripping element of the scissoringmechanism includes a staple cartridge receiving region and a mechanismfor driving the staples up through the clamped end of the tissue,against the anvil portion, thereby sealing the previously opened end.The scissoring elements may be integrally formed with the shaft or maybe detachable such that various scissoring and stapling elements may beinterchangeable.

One problem with the foregoing surgical devices, and in particular withthe foregoing linear clamping, cutting and stapling devices such as thatillustrated in FIG. 1, is the tendency of the opposing jaws of theclamping mechanism to be urged apart during the operation of cutting andstapling the tissue. Another problem with the foregoing surgicaldevices, and in particular with the foregoing linear clamping, cuttingand stapling devices such as that illustrated in FIG. 1, is that thedevices are difficult to maneuver. Because a linear clamping, cuttingand stapling device may be employed corporeally, e.g., inside the bodyof a patient, the device must be small enough to be maneuvered insidethe body of a patient. Conventional linear clamping, cutting andstapling devices such as that illustrated in FIG. 1 have an overalllength which increases the difficulty in maneuvering the device,especially inside the patient's body.

Still another problem with the foregoing surgical devices, and inparticular with the foregoing linear clamping, cutting and staplingdevices such as that illustrated in FIG. 1, is that the torque requiredto cut and staple a section of tissue is undesirably high, therebycausing stress in various components of the devices. For instance, inother linear clamping, cutting and stapling devices which movescissoring and stapling elements from the proximal end to the distalend, a high torque is required to move the scissoring and staplingelements when the scissoring and stapling elements are at the distalend. Thus, when the cutting and stapling element has traveled to thedistal end of the jaws, the high torque causes stress in the scissoringand stapling elements, and driver mechanisms of the device.

SUMMARY OF THE INVENTION

The present invention, according to one example embodiment thereof,relates to a surgical device, which includes a first jaw and a secondjaw disposed in opposed correspondence with the first jaw. The secondjaw is mechanically coupled to the first jaw at a proximal end oppositea distal end. A cutting element, having a blade facing the proximal end,is disposed within the second jaw, and a first driver is configured tomove the cutting element from the distal end to the proximal end of thesecond jaw to thereby cut a section of tissue disposed between the firstand second jaws.

According to an example embodiment, the device may include a staplingelement disposed within the second jaw, wherein the cutting element andthe stapling element are contiguous so as to define a single cutting andstapling element, such as a wedge having a blade disposed thereon. Asthe wedge is moved from the distal end of the second jaw to the proximalend, the wedge urges staples against opposing staple guides disposed inthe first jaw in order to staple a section of tissue while the bladecuts the section of tissue.

By moving the cutting and stapling element from the distal end of themechanism to the proximal end during the cutting and stapling operation,the example embodiment may reduce the tendency of the upper and lowerjaws to separate during operation of the device. Specifically, by movingthe cutting and stapling element from the distal end of the mechanism tothe proximal end during the cutting and stapling operation, there may bea resulting reduction in the distance between the upper and lower jawsat their distal ends.

In addition, by moving the cutting and stapling element from the distalend of the mechanism to the proximal end during the cutting and staplingoperation, the example embodiment may reduce the torque which isrequired during the cutting and stapling operation, thereby reducing thestress which is experienced by various components of the surgicaldevice. By housing the cutting and stapling elements at the distal endof the mechanism, the example embodiment may also reduce the length ofthe surgical device relative to a conventional linear clamping, cuttingand stapling device, thereby improving the device's maneuverability,especially when employed inside the body of a patient, and may enablethe stroke (e.g., the distance which can be cut and stapled) to belengthened so as to clamp, cut and staple a larger section of tissuethan a conventional linear clamping, cutting and stapling device.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a perspective view of a conventional linear clamping, cuttingand stapling device;

FIG. 2 is a perspective view of an electro-mechanical surgical systemaccording to one example embodiment of the present invention;

FIGS. 3 and 4 are side views of the closed and open dispositions,respectively, of a linear clamping, cutting and stapling attachmentaccording to one example embodiment of the present invention;

FIGS. 5 and 6 are side sectional views of the closed and opendispositions, respectively, of the linear clamping, cutting and staplingattachment illustrated in FIGS. 3 to 4;

FIG. 5A is another sectional view of the closed disposition of thelinear clamping, cutting and stapling attachment illustrated in FIGS. 3to 6;

FIGS. 7 to 14 are rear sectional views of the linear clamping, cuttingand stapling attachment illustrated in FIGS. 3 to 6;

FIGS. 15 to 19 are bottom, top sectional, deep top sectional, bottomsectional, and top views, respectively, of the linear clamping, cuttingand stapling attachment illustrated in FIGS. 3 to 14;

FIG. 20 is a side sectional of the linear clamping, cutting and staplingattachment illustrated in FIGS. 3 to 19;

FIG. 21 is a side elevational view, partially in section, of a flexibleshaft of the electro-mechanical surgical device according to one exampleembodiment of the present invention;

FIG. 22 is a cross-sectional view of the flexible shaft taken along theline 22-22 shown in FIG. 21;

FIG. 23 is a rear end view of a first coupling of the flexible shaftillustrated in FIG. 21;

FIG. 24 is a front end view of a second coupling of the flexible shaftillustrated in FIG. 21;

FIG. 25 is a schematic view illustrating a motor arrangement of theelectro-mechanical surgical device illustrated in FIG. 2;

FIG. 26 is a schematic view of the electro-mechanical surgical deviceillustrated in FIG. 2;

FIG. 27 is a schematic view of an encoder of the flexible shaftillustrated in FIG. 21;

FIG. 28 is a schematic view of a memory device of a linear clamping,cutting and stapling device according to one example embodiment of thepresent invention;

FIG. 29 is a schematic view of a wireless remote control unit of theelectro-mechanical surgical device illustrated in FIG. 2;

FIG. 30 is a schematic view of a wired remote control unit of theelectro-mechanical surgical device illustrated in FIG. 2; and

FIGS. 31 to 33 are side sectional views of the closed disposition of thelinear clamping, cutting and stapling attachment illustrating a cuttingelement which is moveably coupled to the stapling element according toone example embodiment of the present invention.

DETAILED DESCRIPTION

One example embodiment of a surgical device according to the presentinvention is illustrated in FIGS. 3 to 20. Referring to FIGS. 3 and 4,an example embodiment of the surgical device 11, e.g., a linearclamping, cutting and stapling device, is illustrated. In thisembodiment, a device 11 includes a parallel separating jaw system havinga lower jaw 50 in opposite correspondence to an upper jaw 80 having aproximal end 100. FIG. 3 illustrates the device 11 in a closed position,in which the lower jaw 50 and the upper jaw 80 are in contact at boththeir proximal and distal ends. FIG. 4 illustrates the device 11 in anopen position, wherein the lower jaw 50 and the upper jaw 80 areseparated. For the purposes of illustration only, FIGS. 3 to 20illustrate the opposing jaws 50 and 80, which remain parallel relativeto each other. In an alternative example embodiment, opposing jaws 50and 80 may open and close in scissor-like fashion, wherein the proximalends of opposing jaws 50 and 80 are mechanically connected by a hinge orother rotational element such that the upper jaw 50 is rotatably coupledto the lower jaw 80.

FIG. 5 is a side sectional view of the surgical device 11 in the closedposition, corresponding to the view shown in FIG. 3. FIG. 6, on theother hand, is a side sectional view of the surgical device 11 in theopen position, corresponding to the view shown in FIG. 4. Referring nowto either FIG. 5 or FIG. 6, the proximal end 100 of the upper jaw 80includes a pair of threaded vertical bores 90, through which extend acorresponding pair of vertical shafts 130. Inner threads 92 of thevertical bores 90 match outer threads 132 of the vertical shafts 130.The vertical shafts 130 engage a threaded upper horizontal shaft 151 ata distal end 140 of the upper horizontal shaft 151. The outer threads152 of the upper horizontal shaft 151 interlock with the outer threads132 of the vertical shafts 130. The upper horizontal shaft 151 includesan upper drive socket 180 at a proximal end 170.

FIG. 5A is another sectional view of the closed disposition of thesurgical device 11 illustrated in FIGS. 3 and 4, according to an exampleembodiment of the present invention. FIG. 5A illustrates the surgicaldevice 11 coupled (removably or permanently) to an electro-mechanicalsurgical system 510. The surgical device 11 includes a first driver 261which is coupled to a first motor 576 of the system 510 by a first driveshaft 532. As will be explained in more detail below, the first driver261, when engaged by the system 510, operates to drive a cutting andstapling element within the lower jaw 50. In addition, the surgicaldevice 11 includes a second driver 150, which is coupled to a secondmotor 580 of system 510 by a second drive shaft 530. As will beexplained in more detail below, second driver 150, when engaged bysystem 510, operates to open and close upper jaw 80 relative to lowerjaw 50.

Referring again to FIGS. 5 and 6, the surgical device 11 furtherincludes a cutting element and a stapling element, which includes awedge 270, having a blade 51 disposed thereon. In an alternative exampleembodiment, the cutting and stapling elements may be separatelydisposed. In the example embodiment, the blade 51 includes a cuttingedge 51 a that faces the proximal end 170 of the surgical device 11. Inthe lower jaw 50 is disposed a tray 220, which may be replaceable,housing one or more fasteners, e.g., staples 230, and in the upper jaw80 is disposed one or more staple guides 240 corresponding to thestaples 230. Each of the staples 230 includes a butt 232 protrudingbelow the tray 220 and a pair of prongs 234 extending to the top of thetray 220. The surgical device 11 further includes a wedge guide orchannel 250 extending beneath the tray 220. Within the channel 250extends a threaded lower horizontal shaft 260 having outer threads 262.Upon the lower horizontal shaft 260 travels the wedge 270 having asloped top face 280, a horizontal threaded bore 290 coaxial with thechannel 250, having inner threads 292 matching the outer threads 262 ofthe lower horizontal shaft 260, and an upwardly extending blade member51. As previously mentioned, the blade member 51 includes a cutting edge51 a facing the proximal end 170 of the surgical device 11. The lowerhorizontal shaft 260 has at a proximal end 300 a second drive socket310.

In the example embodiment illustrated, the surgical device 11 alsoincludes a first sensor electrode 182 electrically communicating viacommunication wires with a first contact pad 187 which electricallycommunicates with a second contact pad 189 via, e.g., direct contact.The second contact pad 189 electrically communicates via thecommunication wires 188 a with a first contact node 188. Similarly, thesurgical device 11 further includes a second sensor electrode 184electrically communicating via communication wires with a second contactnode 186 (illustrated in FIG. 7). The contact nodes 186, 188electrically communicate with communication wires (not shown) in theelectro-mechanical drive component 510 to form a sensor circuit, suchthat when the upper jaw 80 and the lower jaw 50 are clamped together,the sensor electrodes 182, 184 are in contact, the sensor circuit isclosed, and the operator is alerted via other circuit components(discussed in greater detail below) to the clamped position of the jaws50, 80. The operator is therefore informed that it is safe and/orappropriate to begin a cutting and stapling process.

FIG. 7 is a rear sectional view, taken along the line 7-7, of thesurgical device 11 illustrated in FIG. 5. FIG. 7 illustrates secondcontact node 186, as well as upper drive socket 180 for engaging a firstdrive shaft and lower drive socket 310 for engaging a second driveshaft. FIG. 7 also illustrates data connector 1272 coupled to a datamemory unit 1174 (illustrated in FIGS. 5 and 6), the purpose andoperation of which are discussed in greater detail below. FIG. 8 is arear sectional view, taken along the line 8-8, of the surgical device 11illustrated in FIG. 5. FIG. 9 is a rear sectional view, taken along theline 9-9, of the surgical device 11 illustrated in FIG. 5. FIG. 10 is arear sectional view, taken along the line 10-10, of the surgical device11 illustrated in FIG. 5.

FIG. 11 is a rear sectional view, taken along the line 11-11, of thesurgical device 11 illustrated in Figure. FIG. 12 is a rear sectionalview, taken along the line 12-12, of the surgical device 11 illustratedin FIG. 6. FIG. 13 is a rear view, taken along the line 13-13, of thesurgical device 11 illustrated in FIG. 6. FIG. 14 is a rear view, takenalong the line 14-14, of the surgical device 11 illustrated in FIG. 6.

FIG. 15 is a bottom view, taken along the line 15-15, of the surgicaldevice 11 illustrated in FIGS. 5 and 6. FIG. 16 is a top sectional view,taken along the line 16-16, of the surgical device 11 illustrated inFIGS. 5 and 6. FIG. 17 is a deep top sectional view, taken along theline 17-17, of the surgical device 11 illustrated in FIGS. 5 and 6. FIG.18 is a bottom sectional view, taken along the line 18-18, of thesurgical device 11 illustrated in FIGS. 5 and 6. FIG. 19 is a top view,taken along the line 19-19, of the surgical device 11 illustrated inFIGS. 5 and 6. FIG. 20 is a side sectional view, taken along the line20-20, of the surgical device 11 illustrated in FIGS. 5 and 6.

Each of the example embodiments described above include a wedge 270having a blade 51 fixedly disposed thereon. According to another exampleembodiment of the present invention, the surgical device 11 includes ablade which is moveably coupled or mounted to a wedge so that the blademay move between a first position and a second position relative to thewedge. According to one embodiment, a first position of the bladerelative to the wedge may be in a retracted position, whereas a secondposition of the blade relative to the wedge may be in an operableposition, e.g., wherein the cutting edge of the blade faces the proximalend of the lower jaw 50 of the surgical device 11.

FIGS. 31 through 33 illustrate an example embodiment, wherein thesurgical device 11 includes a blade 651 rotatably coupled to a wedge 670so as to rotate between a first and a second position. The operation ofthe surgical device 11 shown in FIGS. 31 through 33 is discussed ingreater detail below. FIGS. 31 through 33 illustrate the wedge 270located at the distal end of the lower jaw 50. The blade 651 isrotatably mounted to the wedge 270 by a pivot member 652. The blade 651includes a cutting edge 651 a that is initially disposed in a retractedor down position, e.g., facing lower horizontal shaft 260. The blade 651also includes a tail region 654 having an actuating pin receiving face653 which initially faces the proximal end 170 of the surgical device11. Located adjacent to actuating pin receiving face 653 is fixedactuating pin 655, which according to the example embodimentillustrated, is fixedly attached to lower jaw 50.

According to one example embodiment of the present invention, thesurgical device 11 may be configured as an attachment to, or may beintegral with, an electro-mechanical surgical system, such aselectro-mechanical surgical system 510. In another embodiment, thesurgical device may be configured as an attachment to, or may integralwith, a purely mechanical device driver system, such as that illustratedin FIG. 1.

FIG. 2 is a perspective view of an example embodiment of anelectro-mechanical surgical system 510 according to the presentinvention. Electro-mechanical surgical system 510 may include, forexample, a remote power console 512, which includes a housing 514 havinga front panel 515. Mounted on front panel 515 are a display device 516and indicators 518 a, 518 b, which are more fully described hereinbelow.A flexible shaft 520 may extend from housing 514 and may be detachablysecured thereto via a first coupling 522. The distal end 524 of flexibleshaft 520 may include a second coupling 526 adapted to detachablysecure, e.g., the surgical device 11 described above, to the distal end524 of flexible shaft 520. It is noted, however, that the secondcoupling 526 may also be adapted to detachably secure a differentsurgical instrument or attachment. In another embodiment, the distal end524 of the flexible shaft 520 may permanently secure or be integral witha surgical instrument.

Referring to FIG. 21, there is seen a side view, partially in section,of flexible shaft 520. According to one embodiment, flexible shaft 520includes a tubular sheath 528, which may include a coating or othersealing arrangement to provide a fluid-tight seal between the interiorchannel 540 thereof and the environment. Sheath 528 may be formed of atissue-compatible, sterilizable elastomeric material. The sheath 528 mayalso be formed of a material that is autoclavable. Disposed within theinterior channel 540 of flexible shaft 520, and extending along theentire length thereof, may be a second rotatable drive shaft 530, afirst rotatable drive shaft 532, a first steering cable 534, a secondsteering cable 535, a third steering cable 536, a fourth steering cable537 and a data transfer cable 538. FIG. 22 is a cross-sectional view offlexible shaft 520 taken along the line 22-22 shown in FIG. 21 andfurther illustrates the several cables 530, 532, 534, 535, 536, 537,538. Each distal end of the steering cables 534, 535, 536, 537 isaffixed to the distal end 524 of the flexible shaft 520. Each of theseveral cables 530, 532, 534, 535, 536, 537, 538 may be contained withina respective sheath.

The second rotatable drive shaft 530 and the first rotatable drive shaft532 may be configured, for example, as highly flexible drive shafts,such as, for example, braided or helical drive cables. It should beunderstood that such highly flexible drive cables have limited torquetransmission characteristics and capabilities. It should also beunderstood that the surgical device 11 (or other attachments connectedto the flexible shaft 520) may require a higher torque input than thetorque transmittable by the drive shafts 530, 532. The drive shafts 530,532 may thus be configured to transmit low torque but high speed, thehigh speed/low torque being converted to low speed/high torque bygearing arrangements disposed, for example, at the distal end and/or theproximal end of the drive flexible shaft 520, in the surgical instrumentor attachment and/or in the remote power console 512. It should beappreciated that such gearing arrangement(s) may be provided at anysuitable location along the power train between the motors disposed inthe housing 514 and the attached surgical instrument or other attachmentconnected to the flexible shaft 520. Such gearing arrangement(s) mayinclude, for example, a spur gear arrangement, a planetary geararrangement, a harmonic gear arrangement, cycloidal drive arrangement,an epicyclic gear arrangement, etc.

Referring now to FIG. 23, there is seen a rear end view of firstcoupling 522. First coupling 522 includes a first connector 544, asecond connector 548, a third connector 552 and a fourth connector 556,each rotatably secured to first coupling 522. Each of the connectors544, 548, 552, 556 includes a respective recess 546, 550, 554, 558. Asshown in FIG. 23, each recess 546, 550, 554, 558 may be hexagonallyshaped. It should be appreciated, however, that the recesses 546, 550,554, 558 may have any shape and configuration to non-rotatably coupleand rigidly attach the connectors 544, 548, 552, 556 to respective driveshafts of the motor arrangement contained within the housing 512, asmore fully described below. It should be appreciated that complementaryprojections may be provided on respective drive shafts of the motorarrangement to thereby drive the drive elements of the flexible shaft520 as described below. It should also be appreciated that the recessesmay be provided on the drive shafts and complementary projections may beprovided on the connectors 544, 548, 552, 556. Any other couplingarrangement configured to non-rotatably and releasably couple theconnectors 544, 548, 552, 556 and the drive shafts of the motorarrangement may be provided.

One of the connectors 544, 548, 552, 556 is non-rotatably secured to thesecond drive shaft 530, and another one of the connectors 544, 548, 552,556 is non-rotatably secured to the first drive shaft 532. The remainingtwo of the connectors 544, 548, 552, 556 engage with transmissionelements configured to apply tensile forces on the steering cables 534,535, 536, 537 to thereby steer the distal end 524 of the flexible shaft520. The data transfer cable 538 is electrically and logically connectedwith data connector 560. Data connector 560 includes, for example,electrical contacts 562, corresponding to and equal in number to thenumber of individual wires contained in the data cable 538. Firstcoupling 522 includes a key structure 542 to properly orient the firstcoupling 522 to a mating and complementary coupling arrangement disposedon the housing 512. Such key structure 542 may be provided on eitherone, or both, of the first coupling 522 and the mating and complementarycoupling arrangement disposed on the housing 512. First coupling 522 mayinclude a quick-connect type connector, which may use, for example, asimple pushing motion to engage the first coupling 522 to the housing512. Seals may be provided in conjunction with any of the severalconnectors 544, 548, 552, 556, 560 to provide a fluid-tight seal betweenthe interior of first coupling 522 and the environment.

Referring now to FIG. 24, there is seen a front end view of the secondcoupling 526 of flexible shaft 520. In the example embodiment, thesecond coupling 526 includes a first connector 566 and a secondconnector 568, each being rotatably secured to the second coupling 526and each being non-rotatably secured to a distal end of a respective oneof the first and second drive shafts 532, 530. A quick-connect typefitting 564 is provided on the second coupling 526 for detachablysecuring the device 11 thereto. The quick-connect type fitting 564 maybe, for example, a rotary quick-connect type fitting, a bayonet typefitting, etc. A key structure 574 is provided on the second coupling 526for properly aligning the device 11 to the second coupling 526. The keystructure or other arrangement for properly aligning the device 11 tothe flexible shaft 520 may be provided on either one, or both, of thesecond coupling 526 and the device 11. In addition, the quick-connecttype fitting may be provided on the device 11. A data connector 570,having electrical contacts 572, is also provided in the second coupling526. Like the data connector 560 of first coupling 522, the dataconnector 570 of second coupling 526 includes contacts 572 electricallyand logically connected to the respective wires of data transfer cable538 and contacts 562 of data connector 560. Seals may be provided inconjunction with the connectors 566, 568, 570 to provide a fluid-tightseal between the interior of second coupling 526 and the environment.

Disposed within housing 514 of the remote power console 512 areelectro-mechanical driver elements configured to drive the drive shafts530, 532 and the steering cables 534, 535, 536, 537 to thereby operatethe electro-mechanical surgical system 510 and the linear clamping,cutting and stapling device 11 attached to the second coupling 526. Inthe example embodiment illustrated schematically in FIG. 25, fiveelectric motors 576, 580, 584, 590, 596, each operating via a powersource, may be disposed in the remote power console 512. It should beappreciated, however, that any appropriate number of motors may beprovided, and the motors may operate via battery power, line current, aDC power supply, an electronically controlled DC power supply, etc. Itshould also be appreciated that the motors may be connected to a DCpower supply, which is in turn connected to line current and whichsupplies the operating current to the motors.

FIG. 25 illustrates schematically one possible arrangement of motors. Anoutput shaft 578 of a first motor 576 engages with the first connector544 of the first coupling 522 when the first coupling 522, and,therefore, flexible shaft 520, is engaged with the housing 514 tothereby drive the second drive shaft 530 and first connector 566 ofsecond coupling 526. Similarly, an output shaft 582 of a second motor580 engages the second connector 548 of first coupling 522 when firstcoupling 522, and, therefore, flexible shaft 520 is engaged with thehousing 514 to thereby drive the first drive shaft 532 and secondconnector 568 of second coupling 526. An output shaft 586 of a thirdmotor 584 engages the third connector 552 of the first coupling 522 whenthe first coupling 522, and, therefore, flexible shaft 520, is engagedwith the housing 514 to thereby drive the first and second steeringcables 534, 535 via a first pulley arrangement 588. An output shaft 592of a fourth motor 590 engages the fourth connector 556 of the firstcoupling 522 when the first coupling 522, and, therefore, flexible shaft520, is engaged with the housing 514 to thereby drive the third andfourth steering cables 536, 537 via a second pulley arrangement 594. Thethird and fourth motors 584, 590 may be secured on a carriage 1100,which is selectively movable via an output shaft 598 of a fifth motor596 between a first position and a second position to selectively engageand disengage the third and fourth motors 584, 590 with the respectivepulley arrangement 588, 594 to thereby permit the flexible shaft 520 tobecome taut and steerable or limp as necessary. It should be appreciatedthat other mechanical, electrical or electro-mechanical mechanisms maybe used to selectively engage and disengage the steering mechanism. Themotors may be arranged and configured as described, for example, in U.S.patent application Ser. No. 09/510,923, entitled “A Carriage Assemblyfor Controlling a Steering Wire Mechanism Within a Flexible Shaft,”which is hereby incorporated by reference herein as fully as if setforth in its entirety.

It should be appreciated, that any one or more of the motors 576, 580,584, 590, 596 may be high-speed/low-torque motors orlow-speed/high-torque motors. As indicated above, the second rotatabledrive shaft 530 and the first rotatable drive shaft 532 may beconfigured to transmit high speed and low torque. Thus, the first motor576 and the second motor 580 may be configured as high-speed/low-torquemotors. Alternatively, the first motor 576 and the second motor 580 maybe configured as low-speed/high-torque motors with atorque-reducing/speed-increasing gear arrangement disposed between thefirst motor 576 and the second motor 580 and a respective one of thesecond rotatable drive shaft 530 and the first rotatable drive shaft532. Such torque-reducing/speed-increasing gear arrangement may include,for example, a spur gear arrangement, a planetary gear arrangement, aharmonic gear arrangement, cycloidal drive arrangement, an epicyclicgear arrangement, etc. It should be appreciated that any such geararrangement may be disposed within the remote power console 512 or inthe proximal end of the flexible shaft 520, such as, for example, in thefirst coupling 522. It should be appreciated that the geararrangement(s) are provided at the distal and/or proximal ends of thesecond rotatable drive shaft 530 and/or the first rotatable drive shaft532 to prevent windup and breakage thereof.

Referring now to FIG. 26, there is seen a schematic view of the exampleelectro-mechanical surgical system 510. A controller 1122 is provided inthe housing 514 of remote power console 512 and is configured to controlall functions and operations of the electro-mechanical surgical system510 and the linear clamping, cutting and stapling device 11 attached tothe flexible shaft 520. A memory unit 1130 is provided and may includememory devices, such as, a ROM component 1132 and/or a RAM component1134. ROM component 1132 is in electrical and logical communication withcontroller 1122 via line 1136, and RAM component 1134 is in electricaland logical communication with controller 1122 via line 1138. RAMcomponent 1134 may include any type of random-access memory, such as,for example, a magnetic memory device, an optical memory device, amagneto-optical memory device, an electronic memory device, etc.Similarly, ROM component 1132 may include any type of read-only memory,such as, for example, a removable memory device, such as a PC-Card orPCMCIA-type device. It should be appreciated that ROM component 1132 andRAM component 1134 may be embodied as a single unit or may be separateunits and that ROM component 1132 and/or RAM component 1134 may beprovided in the form of a PC-Card or PCMCIA-type device.

Controller 1122 is further connected to front panel 515 of housing 514and, more particularly, to display device 516 via line 1154 andindicators 518 a, 518 b via respective lines 1156, 1158. Lines 1116,1118, 1124, 1126, 1128 electrically and logically connect controller1122 to first, second, third, fourth and fifth motors 576, 580, 584,590, 596, respectively. A wired remote control unit (“RCU”) 1150 iselectrically and logically connected to controller 1122 via line 1152. Awireless RCU 1148 is also provided and communicates via a wireless link1160 with a receiving/sending unit 1146 connected via line 1144 to atransceiver 1140. The transceiver 1140 is electrically and logicallyconnected to controller 1122 via line 1142. Wireless link 1160 may be,for example, an optical link, such as an infrared link, a radio link orany other form of wireless communication link.

A switch device 1186, which may be, for example, an array of DIPswitches, may be connected to controller 1122 via line 1188. Switchdevice 1186 may be used, for example, to select one of a plurality oflanguages used in displaying messages and prompts on the display device516. The messages and prompts may relate to, for example, the operationand/or the status of the electro-mechanical surgical system 510 and/orto the surgical device 11 attached thereto.

According to the example embodiment of the present invention, a firstencoder 1106 is provided within the second coupling 526 and isconfigured to output a signal in response to and in accordance with therotation of the second drive shaft 530. A second encoder 1108 is alsoprovided within the second coupling 526 and is configured to output asignal in response to and in accordance with the rotation of the firstdrive shaft 532. The signal output by each of the encoders 1106, 1108may represent the rotational position of the respective drive shaft 530,532 as well as the rotational direction thereof. Such encoders 1106,1108 may be, for example, Hall-effect devices, optical devices, etc.Although the encoders 1106, 1108 are described as being disposed withinthe second coupling 526, it should be appreciated that the encoders1106, 1108 may be provided at any location between the motor system andthe linear clamping, cutting and stapling device. It should beappreciated that providing the encoders 1106, 1108 within the secondcoupling 526 or at the distal end of the flexible shaft 520 provides foran accurate determination of the drive shaft rotation. If the encoders1106, 1108 are disposed at the proximal end of the flexible shaft 520,windup of the first and second rotatable drive shafts 532, 530 mayresult in measurement error.

FIG. 27 is a schematic view of an encoder 1106, 1108, which includes aHall-effect device. Mounted non-rotatably on drive shaft 530, 532 is amagnet 1240 having a north pole 1242 and a south pole 1244. The encoder1106, 1108 further includes a first sensor 1246 and second sensor 1248,which are disposed approximately 90° apart relative to the longitudinal,or rotational, axis of drive shaft 530, 532. The output of the sensors1246, 1248 is persistent and changes its state as a function of a changeof polarity of the magnetic field in the detection range of the sensor.Thus, based on the output signal from the encoders 1106, 1108, theangular position of the drive shaft 530, 532 may be determined withinone-quarter revolution and the direction of rotation of the drive shaft530, 532 may be determined. The output of each encoder 1106, 1108 istransmitted via a respective line 1110, 1112 of data transfer cable 538to controller 1122. The controller 1122, by tracking the angularposition and rotational direction of the drive shafts 530, 532 based onthe output signal from the encoders 1106, 1108, can thereby determinethe position and/or state of the components of the linear clamping,cutting and stapling device connected to the electro-mechanicalsurgical-system 510. That is, by counting the revolutions of the driveshaft 530, 532, the controller 1122 can determine the position and/orstate of the components of the linear clamping, cutting and staplingdevice connected to the electro-mechanical surgical system 510.

For instance, the advancement distance of upper jaw 80 relative to lowerjaw 50, and of the wedge 270 are functions of, and ascertainable on thebasis of, the rotation of the respective drive shaft 530, 532. Byascertaining an absolute position of the jaw 80 and the wedge 270 at apoint in time, the relative displacement of the jaw 80 and wedge 270,based on the output signal from the encoders 1106, 1108 and the knownpitches of the vertical drive shaft 1132 and lower horizontal shaft 260,may be used to ascertain the absolute position of the jaw 80 and thewedge 270 at all times thereafter. The absolute position of the jaw 80and the wedge 270 may be fixed and ascertained at the time that thesurgical device 11 is first coupled to the flexible shaft 520.Alternatively, the position of the jaw 80 and the wedge 270 relative to,for example, the lower jaw 50 may be determined based on the outputsignal from the encoders 1106, 1108.

The surgical device 11 may further include, according to one embodimentand as illustrated in FIG. 5, a data connector 1272 adapted by size andconfiguration to electrically and logically connect to connector 570 ofsecond coupling 526. In the example embodiment, data connector 1272includes contacts equal in number to the number of leads 572 ofconnector 570. Contained within the surgical device 11 is a memory unit1174 electrically and logically connected with the data connector 1272.Memory unit 1174 may be in the form of, for example, an EEPROM, EPROM,etc. and may be contained, for example, within the lower jaw 50 of thesurgical device 11.

FIG. 28 schematically illustrates the memory unit 1174. As seen in FIG.28, data connector 1272 includes contacts 1276, each electrically andlogically connected to memory unit 1174 via a respective line 1278.Memory unit 1174 is configured to store, for example, a serial numberdata 1180, an attachment type identifier (ID) data 1182 and a usage data1184. Memory unit 1174 may additionally store other data. Both theserial number data 1180 and the ID data 1182 may be configured asread-only data. In the example embodiment, serial number data 1180 isdata uniquely identifying the particular linear clamping, cutting andstapling device, whereas the ID data 1182 is data identifying the typeof the attachment (when, for instance, other types of attachments may beemployed by the device). The usage data 1184 represents usage of theparticular attachment, such as, for example, the number of times theupper jaw 80 of the surgical device 11 has been opened and closed, orthe number of times that the wedge 270 of the surgical device 11 hasbeen advanced or fired.

It should be appreciated that the attachment attachable to the distalend 524 of the flexible shaft 520, e.g., surgical device 11, may bedesigned and configured to be used a single time or multiple times. Theattachment may also be designed and configured to be used apredetermined number of times. Accordingly, the usage data 1184 may beused to determine whether the surgical device 11 has been used andwhether the number of uses has exceeded the maximum number of permitteduses. As more fully described below, an attempt to use the attachmentafter the maximum number of permitted uses has been reached willgenerate an ERROR condition.

Referring again to FIG. 26, in accordance with the example embodiment ofthe present invention, the controller 1122 is configured to read the IDdata 1182 from the memory unit 1174 of surgical device 11 when thesurgical device 11 is initially connected to the flexible shaft 520. Thememory unit 1174 is electrically and logically connected to thecontroller 1122 via line 1120 of data transfer cable 538. Based on theread ID data 1182, the controller 1122 is configured to read or selectfrom the memory unit 1130, an operating program or algorithmcorresponding to the type of surgical instrument or attachment connectedto the flexible shaft 520. The memory unit 1130 is configured to storethe operating programs or algorithms for each available type of surgicalinstrument or attachment, the controller 1122 selecting and/or readingthe operating program or algorithm from the memory unit 1130 inaccordance with the ID data 1182 read from the memory unit 1174 of anattached surgical instrument or attachment. As indicated above, thememory unit 1130 may include a removable ROM component 1132 and/or RAMcomponent 1134. Thus, the operating programs or algorithms stored in thememory unit 1130 may be updated, added, deleted, improved or otherwiserevised as necessary. The operating programs or algorithms stored in thememory unit 1130 may be customizable based on, for example, specializedneeds of the user. A data entry device, such as, for example, akeyboard, a mouse, a pointing device, a touch screen, etc., may beconnected to the memory unit 1130 via, for example, a data connectorport, to facilitate the customization of the operating programs oralgorithms. Alternatively or additionally, the operating programs oralgorithms may be customized and preprogramed into the memory unit 1130remotely from the electro-mechanical surgical system 510. It should beappreciated that the serial number data 1180 and/or usage data 1184 mayalso be used to determine which of a plurality of operating programs oralgorithms is read or selected from the memory unit 1130. It should beappreciated that the operating program or algorithm may alternatively bestored in the memory unit 1174 of the surgical device 11 and transferredto the controller 1122 via the data transfer cable 538. Once theappropriate operating program or algorithm is read or selected by, ortransmitted to, the controller 1122, the controller 1122 causes theoperating program or algorithm to be executed in accordance withoperations performed by the user via the wired RCU 1150 (describedbelow) and/or the wireless RCU 1148 (described below). As indicatedhereinabove, the controller 1122 is electrically and logically connectedwith the first, second, third, fourth and fifth motors 576, 580, 584,590, 596 via respective lines 1116, 1118, 1124, 1126, 1128 and controlssuch motors 576, 580, 584, 590, 596 in accordance with the read,selected or transmitted operating program or algorithm via therespective lines 1116, 1118, 1124, 1126, 1128.

Referring now to FIG. 29, there is seen a schematic view of wireless RCU1148. Wireless RCU 1148 includes a steering controller 1300 having aplurality of switches 1302, 1304, 1306, 1308 arranged under a four-wayrocker 1310. The operation of switches 1302, 1304, via rocker 1310,controls the operation of first and second steering cables 534, 535 viathird motor 584. Similarly, the operation of switches 1306, 1308, viarocker 1310, controls the operation of third and fourth steering cables536, 537 via fourth motor 592. It should be appreciated that rocker 1310and switches 1302, 1304, 1306, 1308 are arranged so that the operationof switches 1302, 1304 steers the flexible shaft 520 in the north-southdirection and that the operation of switches 1306, 1308 steers theflexible shaft 520 in the east-west direction. Reference herein tonorth, south, east and west is made to a relative coordinate system.Alternatively, a digital joystick, analog joystick, etc. may be providedin place of rocker 1310 and switches 1302, 1304, 1306, 1308.Potentiometers or any other type of actuator may also be used in placeof switches 1302, 1304, 1306, 1308.

Wireless RCU 1148 further includes a steering engage/disengage switch1312, the operation of which controls the operation of fifth motor 596to selectively engage and disengage the steering mechanism. Wireless RCU1148 also includes a two-way rocker 1314 having first and secondswitches 1316, 1318 operable thereby. The operation of these switches1316, 1318 controls certain functions of the electro-mechanical surgicalsystem 510 and any surgical instrument or attachment, such as thesurgical device 11, attached to the flexible shaft 520 in accordancewith the operating program or algorithm corresponding to the attacheddevice 11. For example, operation of the two-way rocker 1314 may controlthe opening and closing of the upper and lower jaws of the surgicaldevice 11. Wireless RCU 1148 is provided with yet another switch 1320,the operation of which may further control the operation of theelectro-mechanical surgical system 510 and the device attached to theflexible shaft 520 in accordance with the operating program or algorithmcorresponding to the attached device. For example, operation of theswitch 1320 may initiate the advancement, or firing sequence, of thewedge 270 of the surgical device 11.

Wireless RCU 1148 includes a controller 1322, which is electrically andlogically connected with the switches 1302, 1304, 1306, 1308 via line1324, with the switches 1316, 1318 via line 1326, with switch 1312 vialine 1328 and with switch 1320 via line 1330. Wireless RCU 1148 mayinclude indicators 518 a′, 518 b′, corresponding to the indicators 518a, 518 b of front panel 515, and a display device 516′, corresponding tothe display device 516 of the front panel 515. If provided, theindicators 518 a′, 518 b′ are electrically and logically connected tocontroller 1322 via respective lines 1332, 1334, and the display device516′ is electrically and logically connected to controller 1322 via line1336. Controller 1322 is electrically and logically connected to atransceiver 1338 via line 1340, and transceiver 1338 is electrically andlogically connected to a receiver/transmitter 1342 via line 1344. Apower supply, not shown, for example, a battery, may be provided inwireless RCU 1148 to power the same. Thus, the wireless RCU 1148 may beused to control the operation of the electro-mechanical surgical system510 and the device 11 attached to the flexible shaft 520 via wirelesslink 1160.

Wireless RCU 1148 may include a switch 1346 connected to controller 1322via line 1348. Operation of switch 1346 transmits a data signal to thetransmitter/receiver 1146 via wireless link 1160. The data signalincludes identification data uniquely identifying the wireless RCU 1148.This identification data is used by the controller 1122 to preventunauthorized operation of the electro-mechanical surgical system 510 andto prevent interference with the operation of the electro-mechanicalsurgical system 510 by another wireless RCU. Each subsequentcommunication between the wireless RCU 1148 and the electro-mechanicaldevice surgical 510 may include the identification data. Thus, thecontroller 1122 can discriminate between wireless RCUs and thereby allowonly a single, identifiable wireless RCU 1148 to control the operationof the electro-mechanical surgical system 510 and the device 11 attachedto the flexible shaft 520.

Based on the positions of the components of the device attached to theflexible shaft 520, as determined in accordance with the output signalsfrom the encoders 1106, 1108, the controller 1122 may selectively enableor disable the functions of the electro-mechanical surgical system 510as defined by the operating program or algorithm corresponding to theattached device. For example, for the surgical device 11, the firingfunction controlled by the operation of the switch 1320 is disabledunless the space or gap between lower jaw 50 and upper jaw 80 isdetermined to be within an acceptable range. The space or gap betweenlower jaw 50 and upper jaw 80 is determined based on the output signalfrom the encoders 1106, 1108, as more fully described hereinabove. Itshould be appreciated that, in the example embodiment, the switch 1320itself remains operable but the controller 1122 does not effect thecorresponding function unless the space or gap is determined to bewithin the acceptable range.

Referring now to FIG. 30, there is seen a schematic view of a wired RCU1150. In the example embodiment, wired RCU 1150 includes substantiallythe same control elements as the wireless RCU 1148 and furtherdescription of such elements is omitted. Like elements are noted in FIG.30 with an accompanying prime. It should be appreciated that thefunctions of the electro-mechanical surgical system 510 and the deviceattached to the flexible shaft 520 (e.g., the surgical device 11) may becontrolled by the wired RCU 1150 and/or by the wireless RCU 1148. In theevent of a battery failure, for example, in the wireless RCU 1148, thewired RCU 1150 may be used to control the functions of theelectro-mechanical surgical system 510 and the device attached to theflexible shaft 520.

As described hereinabove, the front panel 515 of housing 514 includesdisplay device 516 and indicators 518 a, 518 b. The display device 516may include an alpha-numeric display device, such as an LCD displaydevice. Display device 516 may also include an audio output device, suchas a speaker, a buzzer, etc. The display device 516 is operated andcontrolled by controller 1122 in accordance with the operating programor algorithm corresponding to the device attached to the flexible shaft520 (e.g., the surgical device 11). If no surgical instrument orattachment is so attached, a default operating program or algorithm maybe read or selected by, or transmitted to, controller 1122 to therebycontrol the operation of the display device 516 as well as the otheraspects and functions of the electro-mechanical surgical system 510. Ifsurgical device 11 is attached to flexible shaft 520, display device 516may display, for example, data indicative of the gap between lower jaw50 and upper jaw 80 as determined in accordance with the output signalof encoders 1106, 1108, as more fully described hereinabove.

Similarly, the indicators 518 a, 518 b are operated and controlled bycontroller 1122 in accordance with the operating program or algorithmcorresponding to the device 11, attached to the flexible shaft 520(e.g., the surgical device 11). Indicator 518 a and/or indicator 518 bmay include an audio output device, such as a speaker, a buzzer, etc.,and/or a visual indicator device, such as an LED, a lamp, a light, etc.If the surgical device 11 is attached to the flexible shaft 520,indicator 518 a may indicate, for example, that the electro-mechanicalsurgical system 510 is in a power ON state, and indicator 518 b may, forexample, indicate whether the gap between lower jaw 50 and upper jaw 80is determined to be within the acceptable range as more fully describedhereinabove. It should be appreciated that although only two indicators518 a, 518 b are described, any number of additional indicators may beprovided as necessary. Additionally, it should be appreciated thatalthough a single display device 516 is described, any number ofadditional display devices may be provided as necessary.

The display device 516′ and indicators 518 a′, 518 b′ of wired RCU 1150and the display device 516″ and indicators 518 a″, 518 b″ of wirelessRCU 1148 are similarly operated and controlled by respective controller1322, 1322′ in accordance with the operating program or algorithm of thedevice attached to the flexible shaft 520.

As previously mentioned, the surgical device 11 may be employed toclamp, cut and staple a section of tissue. The operation of the surgicaldevice 11 will now be described in connection with the removal of acancerous or anomalous section of tissue in a patient's bowel, which is,of course, merely one type of tissue and one type of surgery that may beperformed using the surgical device 11. Generally, in operation, aftercancerous or anomalous tissue has been located in the gastrointestinaltract, the patient's abdomen is initially opened to expose the bowel.Utilizing the remote actuation provided by the electro-mechanicalsurgical system 510, the upper and lower jaws 50, 80 of the surgicaldevice 11 are driven into the open position. The tube of the bowel isthen placed on a side adjacent to the cancerous tissue between thespread jaws. Again, by remote actuation, the second driver is caused toengage in reverse, and the upper jaw closes onto the bowel and the lowerjaw. Once the bowel has been sufficiently clamped, the first driver isengaged, which causes the wedge to advance simultaneously from thedistal end of the attachment to the proximal end thereof, therebycutting and stapling the bowel. This step is then repeated on the otherside of the cancerous tissue, thereby removing the section of bowelcontaining the cancerous tissue, which is stapled on either end toprevent spilling of bowel material into the open abdomen.

More specifically, according to the example embodiment of the presentinvention, the surgical device 11 is coupled to the attachment socket orcoupling 26 of the electro-mechanical driver component 510 such that theupper drive socket 180 engages the corresponding flexible drive shaft530 of the electro-mechanical driver component 510 and the second drivesocket 310 engages the corresponding flexible drive shaft 532 of theelectro-mechanical driver component 510. Thus, rotation of the upperhorizontal shaft 151 is effected by rotation of the upper drive socket180 which is effected by rotation of the corresponding flexible driveshaft 530 of the electro-mechanical driver component 510. Clockwise orcounter-clockwise rotation is achieved depending on the direction of themotor 580. Similarly, rotation of the lower horizontal shaft 260 iseffected by rotation of the second drive socket 310 which is effected byrotation of the corresponding flexible drive shaft 532 of theelectro-mechanical driver component 510. Again, clockwise orcounter-clockwise rotation is achieved depending on the direction of themotor 576.

In order to clamp the exposed ends of the bowel, the upper motor 580corresponding to the upper flexible drive shaft 530 is activated, whichengages the upper drive socket 180 at the proximal end 170 of the upperhorizontal shaft 151, thereby causing the upper horizontal shaft 151 toturn in a first (e.g., clockwise) rotation. When the surgical device 11is in an initial closed state as illustrated in FIG. 5, this firstrotation of the upper horizontal shaft 151 causes the outer threads 152of the upper horizontal shaft 151 to engage the outer threads 132 of thevertical shafts 130, thereby causing the vertical shafts 130 to turn ina similar first (e.g., clockwise) rotation. This rotation of thevertical shafts 130 causes the outer threads 132 of the vertical shafts130 to channel within the inner threads 92 of the vertical bores 90,thereby causing the upper jaw 80 to rise in a continuous fashion (in theembodiment illustrated, in a parallel alignment with the fixed lower jaw50) and begin separating from the lower jaw 50. Continuous operation ofthe motor in this manner eventually places the surgical device 11 in anopen state, providing a space between the upper jaw 80 and the lower jaw50, as illustrated in FIG. 6.

Once the surgical device 11 is in this open state, the tray 220 ofstaples 230 may be accessible, and may be inspected to determine whetherthe staples 230 are ready for the procedure and/or replace the tray 220with a more suitable tray 220. In addition, the status of the surgicaldevice 11 may be determined by the control system 1122 as describedhereinabove. Once the tray 220 is determined to be ready and in place, asection of the colon is placed between the upper jaw 80 and lower jaw50. Thereafter, the upper motor 580 is reversed to effect a second(e.g., counter-clockwise) rotation of the upper horizontal shaft 151,which in turn effects counter-clockwise rotation of the vertical shafts130, which in turn effects a lowering of the upper jaw 80. Continuousoperation of the upper motor 580 in this manner eventually returns thelinear clamping and stapling device to a closed state, in which thedistal end of the bowel is clamped between the upper jaw 80 and thelower jaw 40.

The clamping of the distal end of the bowel is determined in accordancewith the output sensors 1246 and 1248 or output electrodes 182, 184 asdescribed above. Circuit components in the electro-mechanical surgicalsystem 510 may provide an alert to signal that it is safe and/orappropriate to begin the cutting and stapling procedure. To begin thestapling and cutting procedure, the lower motor 576 of theelectro-mechanical driver component corresponding to the lower flexibledrive shaft 532 is activated, which engages the lower drive socket 310at the proximal end 300 of the lower horizontal shaft 260, therebycausing the lower horizontal shaft 260 to turn in a first (e.g.counter-clockwise) rotation. When the stapling and cutting mechanism isin an initial loaded state, the wedge 270 and the blade 51 associatedtherewith are in the channel 250 at a position farthest from theproximal end 300 of the lower horizontal shaft 260 (i.e., at the distalend). The counter-clockwise rotation of the lower horizontal shaft 260causes the outer threads 262 of the lower horizontal shaft 260 to engagethe inner threads 292 of the horizontal threaded bore 290 of the wedge270, thereby causing the wedge 270 to travel through the channel 250 ina proximal direction toward the proximal end 300 of the lower horizontalshaft 260. Continuous operation of the lower motor 576 in this mannerwill move the wedge 270 fully through the channel 250. As the wedge 270moves through proximally the channel, the blade 51 mounted to the top ofthe wedge cuts through the bowel, thereby transecting it.Simultaneously, the sloped top face 280 of the wedge 270 contacts thebutts 232 of the staples 230, thereby pushing the prongs 234 of thestaples 230 through the tissue of the clamped distal end of bowel andagainst the staple guides 240, which bends and closes the staples 230.When the wedge 270 is moved proximally fully through the channel 250,all of the staples 230 are pushed through the tray 220 and closed,thereby stapling closed the distal end of the bowel on both sides of thecut.

Thereafter, the upper motor 580 is again activated to effect a clockwiserotation of the upper horizontal shaft 151, which in turn effects aclockwise rotation of the vertical shafts 130, which in turn effects araising of the upper jaw 80. Continuous operation of the upper motor 580in this manner eventually returns the surgical device 11 into the openstate. Thereafter, the empty tray 220 is replaced with a full tray 220and the same clamping, cutting and stapling procedure is performed onthe proximal end of the bowel. It should be understood that prior to thesecure clamping, cutting and stapling procedure, the blade 51 and thewedge 270 may be returned to the distal position by operation of thelower motor 576. In order to accomplish this, the lower motor 576 isreversed to effect a clockwise rotation of the lower horizontal shaft260, which in turn moves the wedge 270 away from the proximal end 300 ofthe lower horizontal shaft 260. Continuous operation of the lower motor576 in this manner eventually returns the wedge 270 to its initialposition at the distal end of the mechanism. Once the proximal end ofthe bowel is also clamped, cut and stapled, the attachment (i.e., thesurgical device 11) may be separated from the electro-mechanical drivercomponent and discard the attachment.

As previously mentioned, FIGS. 31 to 33 illustrate an alternativeexample embodiment, wherein the surgical device 11 includes a blade 651rotatably coupled to a wedge 670 so as to rotate between a first and asecond position. The steps performed in order to operate thisalternative example embodiment of the surgical device 11 aresubstantially similar to the steps described above as performed in orderto operate the example embodiment of the surgical device 11 illustratedin FIGS. 5 and 6. The operation of those additional features of thesurgical device 11 of the alternative example embodiment illustrated inFIGS. 31 to 33 will now be described. Referring to FIG. 31, and aspreviously discussed, the wedge 270 is illustrated as being located atthe distal end of the lower jaw 50 after the clamping operation has beenperformed but before the cutting and stapling operation has begun. Theblade 651 is rotatably mounted to the wedge 270 by pivot member 652. Thecutting edge 651 a of the blade 651 is initially disposed in a retractedor down position, e.g., facing lower horizontal shaft 260. The tailregion 654 of the blade 651 is disposed above the wedge 270, so that theactuating pin receiving face 653 initially faces the proximal end 170 ofthe surgical device 11 and is adjacent to fixed actuating pin 655 oflower jaw 50.

FIG. 32 illustrates the surgical device 11 in which the cutting andstapling operation has begun, e.g., by rotating horizontal shaft 260 soas to begin moving the wedge 270 from the distal end of the lower jaw 50toward the proximal end of the lower jaw 50. As illustrated in FIG. 32,the actuating pin receiving face 653 located at the tail region 654 ofblade 651 engages fixed actuating pin 655, causing the blade 651 torotate relative to the wedge 270 around pivot member 652. By rotatingrelative to the wedge 270 around pivot member 652, the cutting edge 651a of the blade 651 is displaced from its initial position facing thelower horizontal shaft 260 and begins to swing upwardly.

FIG. 33 illustrates the surgical device 11 in which the cutting andstapling operation has continued further, e.g., by further rotatinghorizontal shaft 260 so as to continue to move the wedge 270 from thedistal end of the lower jaw 50 toward the proximal end of the lower jaw50. As illustrated in FIG. 33, the wedge 270 has moved proximally farenough toward the proximal end of the lower jaw 50 so as to causeactuating pin receiving face 653 at the tail region 654 of blade 651 tocomplete its engagement with fixed actuating pin 655. At this point, theblade 651 is rotated relative to the wedge 270 around pivot member 652such that the cutting edge 651 a of the blade 651 faces the proximal endof the lower jaw 50.

As previously mentioned, one problem of conventional cutting andstapling devices is that the opposing jaws of the mechanism tend toopen, or be urged apart, during operation. This follows because theforce exerted by the sloped top face 280 of wedge 270 has an upwardcomponent when sloped face 280 contacts the butt 232 of the staples 230in the staple tray 220 and urges the prongs 234 of the staples 230 intothe opposing staple guides 240. As prongs 234 contact guides 240, theforce of the contact tends to separate, or urge apart, the upper andlower jaws until the prongs 234 of the staples are bent by guides 240into a closed position. If the upper and lower jaws separate by asufficient distance, the prongs 234 will not be sufficiently bent byguides 240 into the closed position, and the inadequately stapled end ofthe tissue may permit its contents to spill into the open abdomen of thepatient, increasing the likelihood of infection and other complications.

In accordance with the example embodiment of the present invention,movement of the cutting and stapling element, e.g., the wedge 270 andblade 51, from the distal end of the surgical device 11 to the proximalend during the cutting and stapling operation may reduce the tendency ofthe upper and lower jaws to separate, or to be urged apart, during thecutting and stapling operation. Specifically, by moving the cutting andstapling element, e.g., the wedge 270 and the blade 51, from the distalend of the surgical device 11 to the proximal end during the cutting andstapling operation, there may be a resulting reduction in the distancebetween the upper and lower jaws at its distal end. For instance, inlinear clamping, cutting and stapling devices in which a wedge/blade ismoved from the proximal end to the distal end during the stapling andcutting operation, the first staple encountered by the wedge is thestaple that is located closest to the proximal end. When the wedgecontacts the butt of this first staple, the wedge forces the prongs ofthe staple into contact with the opposing staple guide in the upper jaw.Until the prongs have been bent and closed, this contact between theprongs of the staple and the opposing staple guide causes the distancebetween the upper and lower jaws, at the proximal end thereof, toincrease by a small amount. However, because the upper and lower jawsare mechanically, e.g., pivotably, connected at the proximal end but arefree at the distal end, the small increase in the distance between theupper and lower jaws at the proximal end translates into a relativelylarge increase in the distance between the upper and lower jaws at thedistal end. Simultaneously, while the blade is cutting the tissueclamped between the upper and lower jaws, the distal movement of theblade also tends to push the tissue clamped between the upper and lowerjaws toward the distal end of the jaws. Because the jaws have beenforced apart at their distal end, a greater amount (i.e., thickness) oftissue may be accommodated at the distal end of the jaws, and thepushing action of the blade against the tissue tends to push the greateramount of tissue into the space at the distal end of the jaws. Once theadditional tissue is accommodated between the distal ends of the upperand lower jaws, the tissue further acts to force the distal ends of thejaws apart. Thus, when the cutting and stapling element has traveled tothe distal end of the jaws, the distance between the jaws at the distalend may be undesirably large, and effective stapling of the tissuebetween the distal ends of the jaws may be less than optimal.

By contrast, in accordance with the example embodiment of the presentinvention, the first staple 230 encountered by the wedge 270 is thestaple which is located closest to the distal end of the lower jaw 50.When the wedge 270 contacts the butt 232 of this first staple, the wedge270 forces the prongs 234 of the staple 230 into contact with theopposing staple guide 240 in the upper jaw 80. This contact between theprongs 234 of the staple 230 and the opposing staple guide 240 may causethe distance between the upper jaw 80 and the lower jaw 50 at the distalends thereof, to increase by a small amount, because the upper jaw 80and lower jaw 50 are free at their distal end. However, because theupper jaw 80 and lower jaw 50 are mechanically connected at theirproximal ends, the small increase in the distance between the upper jaw80 and lower jaw 50 at their distal end does not translate into acorresponding large increase in the distance between the upper jaw 80and lower jaw 50 at their proximal ends. Furthermore, in the exampleembodiment of the present invention, while the blade 51 is cutting thetissue clamped between the upper jaw 50 and lower jaw 80, the horizontalmovement of the blade 51 tends to push the tissue clamped between theupper jaw 80 and lower jaw 50 towards the proximal end of the jaws.However, because the upper jaw 80 and lower jaw 50 have not been forcedapart at their proximal ends, a greater amount (i.e., thickness) oftissue may not be accommodated at the proximal ends of the jaws, and thecutting force of the blade 51 against the tissue may not tend to push agreater amount of tissue into the space at the proximal end of the jaws.Thus, since no additional tissue may be accommodated between theproximal ends of the upper jaw 80 and the lower jaw 50, the tissue maynot further act to force the proximal ends of the jaws apart. Thus, bythe time the cutting and stapling element, e.g., the blade 51 and thewedge 270, has traveled to the proximal end of the lower jaw 50, thedistance between the lower jaw 50 and the upper jaw 80 at the proximalend may remain substantially unchanged, thereby insuring optimaleffectiveness for stapling of the tissue between the proximal ends ofthe lower and upper jaws 50, 80. Also, when the wedge 270 eventuallycontacts the staples 230 at the proximal end of the jaws 50, 80, thedistance between the upper and lower jaws 50, 80, at their proximal endmay increase by a small amount. However, since the tissue located at thedistal end has already been cut and stapled, any larger distance betweenthe upper jaw 80 and the lower jaw 50 at the distal end at this time isirrelevant. Thus, the present invention insures optimal effectiveness ofstapling by reducing the tendency of the upper and lower jaws toseparate during operation.

The example embodiment of the present invention may also reduce thetorque which is required to move the wedge 270 and may therefore reducethe stress which is experienced by various components of the surgicaldevice. For instance, in linear clamping, cutting and stapling devices,which move a wedge/blade from the proximal end to the distal end, thetorque that is required to move the wedge/blade increases as thewedge/blade moves from the proximal end to the distal end, because thedistance between the wedge/blade and the proximal end of the device (thepoint at which the rotatable drive shaft is coupled to the device)increases. In addition, the torque that is required to move thewedge/blade also increases as the wedge/blade moves from the proximalend to the distal end, because of the additional tissue accommodated atthe distal end of the device. As discussed above, while the blade iscutting the tissue clamped between the upper and lower jaws, the distalmovement of the blade also tends to push the tissue clamped between theupper and lower jaws towards the distal end of the jaws. In order to cutthrough the greater amount (i.e., thickness) of tissue accommodated atthe distal end of the jaws, a greater amount of torque is required to beimparted by the horizontal drive shaft to the wedge/blade. Thus, whenthe cutting and stapling element has traveled to the distal end of thejaws, the torque has increased, thereby causing stress in thewedge/blade, and drive mechanisms of the device.

In contrast, in accordance with the example embodiment of the presentinvention, there may be a reduction in the torque that is required tomove the wedge 270 during the cutting and stapling operation, therebyreducing the stress that is experienced by various components of thesurgical device 11. For instance, in surgical device 11, which moves thewedge 270 and blade 51 from the distal end to the proximal end of thelower jaw 50, the torque that is required to move the wedge 270 and theblade 51 decreases as the wedge 270 and the blade 51 move from thedistal end to the proximal end of lower jaw 50 because the distancebetween the wedge/blade and the proximal end of the device (the point atwhich the rotatable drive shaft is coupled to the device) decreases. Inaddition, the torque that is required to move the wedge/blade alsodecreases as the wedge/blade moves from the distal end of lower jaw 50to the distal end, because there is no additional tissue accommodated atthe proximal end of the jaws 50 and 80. Unlike conventional linearclamping, cutting and stapling devices, while the blade 51 of thesurgical device 11 is cutting the tissue clamped between the upper jaw80 and the lower jaw 50, the proximal movement of the blade 51 does nottend to push the tissue clamped between the upper jaw 80 and the lowerjaw 50 toward the proximal end of the jaws. Thus, since the blade 51 isnot required to cut through a greater amount (i.e., thickness) of tissueaccommodated at the proximal end of the jaws, a greater amount of torqueis not required to be imparted by the lower horizontal shaft 260 to thewedge 270 and the blade 51 in order to cut the tissue. When the wedge270 and the blade 51 have traveled to the proximal end of the lower jaw50, the torque has decreased, thereby reducing the stress in the wedge270, blade 51, first driver 261, etc.

The example embodiment of the present invention may also reduce thelength of a linear clamping, cutting and stapling device, therebyimproving the device's ability to be employed in small spaces. Because alinear clamping, cutting and stapling device may be intended to beemployed corporeally, e.g., inside the body of a patient, the devicemust be small enough to be maneuvered inside the body of the patient. Inconventional linear clamping, cutting and stapling devices, which move awedge/blade from the proximal end to the distal end, the space that isrequired in order to house the wedge/blade at the proximal end of thedevice increases the overall length of the device. This increase in thelength of the device makes the device more difficult to maneuver insidethe patient's body.

In contrast, in accordance with the example embodiment of the presentinvention, the surgical device 11 initially houses wedge 270 and blade51 at the distal end of lower jaw 50, which is unencumbered by thememory unit 1174, vertical drive shafts 130, and various othercomponents that are located at the proximal end of surgical device 11.Thus, by initially disposing the wedge 270 and the blade 51 at thedistal end of lower jaw 50, and by moving the wedge 270 and the blade 51from the distal end of lower jaw 50 to the proximal end, the overalllength of surgical device 11 relative to conventional linear clamping,cutting and stapling devices may be reduced. This decrease in overalllength makes the surgical device 11 easier to maneuver inside thepatient's body, as compared to conventional linear clamping, cutting andstapling devices.

By decreasing the required overall length of surgical device 11 relativeto conventional linear clamping, cutting and stapling devices, accordingto an example embodiment, the surgical device 11 may also provide acorresponding increase (approximately 30%) in the length of its stroke,e.g., the distance which the wedge 270 and the blade 51 may travelduring the cutting and stapling operation, as compared to conventionallinear clamping, cutting and stapling devices. For instance, since theoverall length of surgical device 11 may be reduced (relative to theoverall length of conventional linear clamping, cutting and staplingdevices) due to the space saved by initially positioning the wedge 270and the blade 51 at the distal end, the saved space may also increasethe stroke length of the surgical device 11. Thus, the surgical device11 may be configured, according to one example embodiment, to clamp, cutand staple larger sections of tissue than conventional linear clamping,cutting and stapling devices.

The example embodiment illustrated in FIGS. 31 to 33 may also improvethe safety of the surgical device 11 in that the cutting edge 651 a ofthe blade 651 is retracted, e.g., not exposed, when the wedge 270 is inan initial position at the distal end of lower jaw 50. Specifically,according to this example embodiment, during the stage of the operationwhen the section of tissue to be clamped, cut and stapled is placed andclamped between upper jaw 80 and lower jaw 50 of the surgical device 11,the cutting edge 651 a of the blade 651 is retracted. By retracting thecutting edge 651 a of the blade 651 during this positioning and clampingstage of the operation, the likelihood that the section of tissue willbe inadvertently cut before the section of tissue is adequately clampedmay be decreased. Furthermore, accidental cutting by blade 651 of, forexample, an operator or other equipment, may be reduced by thearrangement of the retracted blade 651. According to the exampleembodiment, only after the section of tissue has been clamped (and ithas been determined that it is appropriate to start the cutting andclamping stage of the operation) is the wedge 270 moved toward theproximal end of the lower jaw 50, thereby causing the cutting edge 651 aof the blade 651 to be disposed in a cutting position, e.g., facing theproximal end of lower jaw 50.

Thus, the several aforementioned objects and advantages of the presentinvention are most effectively attained. Those skilled in the art willappreciate that numerous modifications of the exemplary embodimentdescribed hereinabove may be made without departing from the spirit andscope of the invention. Although a single exemplary embodiment of thepresent invention has been described and disclosed in detail herein, itshould be understood that this invention is in no sense limited thereby.

1-45. (canceled)
 46. A method comprising the steps of: positioning asection of tissue between a first jaw disposed in oppositecorrespondence with a second jaw, the second jaw mechanically coupled tothe first jaw at a proximal end opposite a distal end; and actuating afirst driver coupled to a cutting element disposed within the distal endof the second jaw so as to move the cutting and stapling elementproximally from the distal end toward the proximal end of the secondjaw, thereby cutting the section of tissue disposed between the firstjaw and the second jaw.
 47. The method according to claim 46, whereinthe cutting element further includes a stapling element, wherebyactuation of the first driver simultaneously cuts and staples thesection of tissue.
 48. The method according to claim 46, furthercomprising the step of actuating a second driver coupled to the firstjaw so as to cause the first jaw to close toward the second jaw, therebyclamping the section of tissue between the first and second jaws. 49.The method according to claim 48, wherein the second driver furtherincludes a pair of threaded turning shafts and a horizontal threadedgearing shaft disposed in turning and gearing relationship with the pairof threaded turning shafts, wherein the second driver actuating stepincludes the substep of rotating the horizontal gearing shaft.
 50. Themethod according to claim 48, wherein the second driver includes atleast one threaded turning shaft, and wherein the first jaw includes acorresponding at least one threaded bore for receiving therethrough thethreaded turning shaft, the method further comprising the step ofrotating the turning shaft in a first rotational direction so as tocause the first jaw to move axially along the turning shaft away fromthe second jaw prior to positioning the section of tissue between afirst jaw disposed in opposite correspondence with a second jaw, andwherein the second driver actuating step includes the substep ofrotating the turning shaft in a second rotational direction so as tocause the first jaw to move axially along the turning shaft toward thesecond jaw in order to clamp the section of tissue.
 51. The methodaccording to claim 46, wherein the cutting and stapling element includesa blade and wedge seated in a wedge guide channel formed in the secondjaw.
 52. The method according to claim 46, wherein the second driverincludes a first rotatable shaft configured to effect the travel of thefirst jaw, the first rotatable shaft arranged in parallel to an axis ofparallel correspondence of the first and second jaws when in a closedposition.
 53. The method according to claim 52, wherein the seconddriver actuating step includes the substep of rotating the firstrotatable shaft in a first direction to effect opening of the jaws androtating the first rotatable shaft in a second direction opposite to thefirst direction to effect closing of the jaws.
 54. The method accordingto claim 53, further comprising the steps of: coupling a proximal end ofthe first rotatable shaft to a first rotatable drive shaft of anelectro-mechanical driver device; and rotating the first rotatable shaftby rotation of the first rotatable drive shaft.
 55. The method accordingto claim 46, wherein the first driver includes a second rotatable shaftrotatable about a longitudinal axis arranged in parallel to the axis ofparallel correspondence of the first and second jaws when in a closedposition.
 56. The method according to claim 48, further comprising thesteps of: coupling the second driver to a first rotatable drive shaft ofan electro-mechanical driver device; and coupling the first driver to asecond rotatable drive shaft of the electro-mechanical driver device.57. The method according to claim 56, further comprising the step ofdriving to each of the first and second rotatable drive shafts with atleast one motor arrangement of the electro-mechanical driver device. 58.The method according to claim 56, further comprising the steps ofdriving the first rotatable drive shaft with a first motor arrangementof the electro-mechanical driver device; and driving the secondrotatable drive shaft with a second motor arrangement of theelectro-mechanical driver device.
 59. The method according to claim 57,further comprising the step of driving each of the first driver and thesecond driver with an electro-mechanical driver device.
 60. The methodaccording to claim 59, wherein the step of driving the first driver andthe second driver with an electro-mechanical driver further includes thesubstep of independently driving each of the first driver and the seconddriver.